Program Overview in India

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1 Program Overview in India

2 Every year, nearly 2 million people die from tuberculosis, a curable disease. Poor adherence to the necessary drug regimen and interrupted treatment are widespread problems in resource-constrained countries. These problems not only keep patients from being cured of the disease but also can lead to multi-drug resistant strains of TB, which require even longer and more complex treatment. Conservative estimates indicate that about 500,000 new cases of MDR-TB arise every year, clearly, this pandemic requires a massive mobilization of people and resources to address it. With 1.9 million new TB cases each year, India has the highest incidence of tuberculosis in the world accounting for nearly one-fifth of the global incidence. Though the rate of MDR-TB is relatively low in India, when translated into absolute numbers it comes to an astounding 131,000 cases of MDR-TB. In India today, two people die from TB every three minutes, a staggering number indeed. More unfortunate is the fact that these deaths could easily be avoided. In 2003, Lilly launched a multipronged philanthropic program to fight MDR-TB involving private and public health care professionals, academia, international organizations and producers of medicines in developing regions around the world. The Lilly MDR-TB Partnership has been working in India for last several years with various stakeholders to combat this daunting disease. Under its aegis, it has collaborated with the Government of India s Revised National TB control Program (RNTCP) to assist in implementation of the DOTS Plus Program in various States. It is also working with Institutions like the Indian Medical Association, NGOs and the Industry Associations. In addition, the Partnership also works with different media houses to produce advocacy campaigns aimed at sensitizing decision makers.

3 Community Support and Patient Advocacy Community based Care for MDR TB In Delhi, a team of nurses, dietician and counselor visit the MDR-TB patients to counsel them on treatment completion. Outreach workers provide support to MDR-TB patients in Gujarat. Psycho-social counseling is being provided to patients to ensure treatment adherence to an otherwise difficult treatment regime in West Bengal. The goal everywhere is to improve the treatment outcomes for MDR-TB patients. Youth Peer Educators (YPEs) in action in Kolkata Children International-Sahay is working with 200 youth peer educators (YPE) in two urban slums of Kolkata, West Bengal. This community based intervention supports patients to complete their treatment. These YPE s who are trained to become the change agents, organize activities in their communities to decrease stigma and increase awareness around the disease. Experienced community counselors work with these youth peer educators to guide them in their unique mission. Community based awareness and Prevention Program, Gujarat Self Employed Women s Association (SEWA) is working for TB prevention and control in Ahmedabad. Its health workers are trained on TB program, after which they help in identifying people with symptoms of TB who are then referred to nearest Government health centers for treatment. Tools such as community radio, leaflets, wall paintings and puppet shows are used to communicate the key TB messages providing the community with timely, simple-to-digest information. The intervention also supports women who have been impacted by TB in impoverished areas to become income earners.

4 Transferring Technology This is an initiative wherein Lilly has transferred its full set of manufacturing technology to produce second line anti-tb drugs to domestic Companies in India, South Africa, Russia and China. The rationale behind this free of charge transfer is to create sustainable source for quality second line drugs in these countries. In India, the technology transfer of second line drug Cycloserine has been completed with Shasun Chemicals and Drugs Ltd, Chennai. The initiative includes grants to purchase equipment and upgrade facilities; training in Good Manufacturing Practices (GMP) and learning business management in partnership with Purdue University. Shasun since then has begun to successfully manufacture Cycloserine for commercial use. Treatment, Training and Surveillance Training for Healthcare Providers Engagement of private sector in the TB control program is absolutely essential for the success of the program as more than half the patients seek treatment in the private sector. Training programs for Private Health Practitioners (PHP) are regularly organized by Lilly- MDR TB partnership in Delhi. The participants are trained using a pragmatic approach on the approved guidelines for diagnosis and management of TB and pediatric TB. Case based presentations on the management of MDR TB are used in the training to prevent inadequate and or inappropriate treatment. Information is also shared about TB / HIV co-infection and its screening. Pharmacists Sensitization Program in Mumbai The Government s TB control programme uses Directly Observed Treatment Short course (DOTS) to supervise patients treatment. However an estimated per cent of TB treatment is accessed through private healthcare delivery model where Pharmacists play a key role. With an objective to engage these pharmacists in TB control and also with a view to bring them mainstream in TB diagnosis and treatment, a project is being supported in Mumbai for engaging the Pharmacists in the national TB program. Being implemented by International Pharmaceutical Federation (FIP), SEARPharm Forum & Indian Pharmaceutical Association (IPA) and supported by the Maharashtra State Chemist & Druggist Association & District TB Control Societies, the program has so far trained about 150 pharmacists in Mumbai.

5 Awareness and Prevention Media Award for Excellence in TB Reporting Accurate and informed journalism can have a significant impact on the general understanding of Tuberculosis, a challenging public health concern in India. It is well documented that India bears one-fifth of the world s global TB and that there is growing disposition to multi-drug resistance. Against this backdrop, it becomes imperative to run an awareness campaign that highlights simple facts around TB- for one the fact that it is completely curable. The REACH- Lilly MDR-TB Partnership Media Awards is an initiative that recognizes journalists who produce simple, reader- friendly stories on Tuberculosis. Through this initiative, the Project seeks to highlight the vital role played by the media in informing the public and decisionmakers about TB prevention and care. The project also awards Fellowships to vernacular media journalists interested in writing on local advocacy issues around TB and nominations from across the country are received for the same. The project has also created a valuable resource platform for the media and all other stakeholders utilizing the power of social media. Media Fellowship for Journalists & Media Training REACH, a Chennai-based non-profit centre dedicated to the fight against TB has announced the REACH Lilly MDR-TB Partnership Media Fellowships. This program provides selected journalists from local language newspapers across India with support to undertake indepth analysis of various aspects of TB. The Fellowships are intended to encourage journalists to explore TB as a critical public health concern in India, by identifying and developing stories that remain untold. Media Trainings are organized for civil society partners to build their capacity for working with media.

6 STOP TB Edu-Tainment Pack Interactive CD for Awareness Among Youth and Students Lilly MDR TB Partnership in collaboration with the MoH and Delhi Government s DOTS Program launched an interactive CD with learning modules, games and a quiz based on TB. This tool has been developed to reach out to young people with information along with entertainment. The learning zone covers four self-explanatory simulated modules with voiceover and animations. At the end of the four modules is a summative test to evaluate the knowledge. Stop TB Cricket Also included in the CD is the Interactive Cricket Game based on 20/20 Cricket with messages on TB. Stop TB Quiz An interactive quizzing game show based on Tuberculosis, where the quizmaster puts questions on Tuberculosis. Stop TB Mobile Cricket Mobile Phone based version of the Cricket game has been developed to make young people play and learn about TB, anytime anywhere The CD Rom is being distributed to all partners, schools and to all State Program Officers by the Central TB Division. It is being disseminated in schools for increasing awareness among the target group. Target Audience The target audience for the Interactive CD Rom are: School children College students Computer savvy youth Adolescent children Youth in the age-group of years.

7 Radio Campaign across 13 cities

8 Contact Information Sunita Prasad: Anurag Khera: Eli Lilly and Co. (India) Pvt. Ltd. Plot No.92, Sector 32 Gurgaon Haryana INDIA For more information about The Lilly MDR-TB Partnership, please visit Eli Lilly and Company, Photo courtesy: Eli Lilly and Company

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